The role of imaging in the detection of overt abdominal and chest metastasis due to breast cancer, and associated risk factors at Ocean Road Cancer Institute

Abstract

ABSTRACT Background; Breast cancer is a disease which affects people worldwide, contributing to a substantial public health. It is estimated more than 1.1 million cases of breast cancer are diagnosed each year. This disease accounts for 10% of all cancers and 23% of all cancers in women worldwide. Breast cancer is the leading cause of mortality and morbidity in Asia and Latin America. In Tanzania it is estimated that approximately 1307 women with breast cancer register in different hospitals each year. Cancer of the breast is among the commonest cancers affecting women in Tanzania. The majority of women who are diagnosed with breast cancer seek hospital treatment when the disease has reached an advanced stage, at which point the metastasis of the disease to the lung or the liver are most likely. Broad objectives; To determine the role of imaging in detection of overt abdominal and chest breast cancer metastasis, and associated risk factors among patients at ORCI from June to December 2010. Methods; This was a descriptive cross sectional study in which 103 patients with breast cancer attending ORCI new patient clinic were recruited consecutively. Standardized questionnaires were used to obtain socio-demographic characteristics, risk factors and physical examination details, all participants were then investigated for liver and lung metastases using abdominal ultrasound and chest x-ray respectively. Results; The majority of breast cancer patients studied were above 45years (61.5%) with the mean age of 48(SD) ± (11.22) year, and only 27.2 % had post primary education. The prevalence of metastasis from breast cancer to the liver and lungs was 18.4% and 20.4% respectively. Majority of liver metastasis occurred at the age category of 45years and above, with the prevalence of 68.4%.The prevalence of lung metastasis was highest in the age category of 35-44 years and above. Majority of patients with breast cancer had locally advanced breast cancer disease that is either TNM stage three (59.2%) or four (32%) disease upon arrival to ORCI, only 8.8% had stage two and none had stage one. Conclusion; This study showed that, the prevalence of lung and liver metastasis was very high accounting for 20.4% and 18.4% respectively. This is supported by the fact that most of newly viii diagnosed breast cancer had locally advanced breast cancer at presentation. The results of this study strengthen the recommendation of doing baseline staging tests, especially LUS and CXR, to all new breast cancer patients in Tanzania. This study also showed that, premenopausal women and those who use alcohol have increased prevalence of lung and liver metastasis though the results were not significant.